Expanding a Simulation Program

The Experience at Quinnipiac UniversityMary Ann Cordeau PhD, RN

From participating in this presentation the participant should be able to:

Discuss the process of starting a clinical simulation program

Discuss the process of setting up a simulation laboratory

Discuss the process of expanding a clinical simulation program

Discuss the process of starting an interdisciplinary clinical simulation program

Presentation Outcomes

What we learned at Quinnipiac University

Moving from a Simulation Room

To a simulation suite

Getting started: Mount Carmel Campus (2006)

Some assembly necessary!!!

One Mannequin One patient room with a

control room One instructor One scenario Eighty students!!!!! Number for HELP desk Number for Laerdal

Interested faculty member Supportive Leadership Curriculum plan for incorporating clinical simulation Space Funding Mannequin Faculty Expert(s) (Novice to Expert) Fidelity Environment Accessories Faculty Buy-in Faculty Education Technological Support Maintenance of Lab equipment Management of student experiences Selling the Program Interprofessional use Director of Clinical Simulation

Expanding Clinical Simulation

Department – Chairperson who supports clinical simulation as a teaching learning strategy ◦ 2005 Janice Thompson decided to purchase a SimMan

for the Department and build a simulation lab. ◦ 2008 Plans for move to North Haven and Simulation

Suite with 5 simulation rooms School – Dean who supports clinical simulation University – Understanding of the potential of

clinical simulation as a teaching/learning strategy

Supportive Leadership

Finding a framework to guide the process◦ Orientation ◦ No practice sessions

Simulation outcomes◦ Began in spring semester in our first medical/surgical

course with the care of a postoperative client◦ Wrote a scenario which included scenario outcomes

Created grading rubric Scenario was related to NU 303 as an add on assignment,

Pass/Fail After the second year, I presented a potential plan for

incorporating clinical simulation into all courses Research on the Experience of Clinical Simulation

Introduction of Clinical Simulation

Look to the literature for information on best practices for clinical simulation

Examine program/course outcomes to determine how clinical simulation will be used to meet outcomes

The use of clinical simulation needs to be examined for each course◦ Number and type of experiences◦ Use of clinical simulation in the class room

Teaching content, Practice, Nursing experience, Team work, Evaluation Attach % points, Pass/Fail, Letter, number grade

Plan for incorporating clinical simulation into curriculum

Plan for incorporating clinical simulation into curriculum

Don’t jump into the water unless you know what is there!!

Start with a written scenario: Laerdal, International Nursing Association for Clinical Simulation and Learning (INACSL), Colleague

Start with one course Conduct a Pilot study

◦ Uncover what needs to be changed

Current Use: Fundamentals Course – Fall Junior Year

◦ Therapeutic communication, Client Safety Medical/surgical Course – Spring Junior Year

◦ Post-operative assessment, Medication Administration Maternity Course – Spring Junior Year

◦ Assessment Medical/surgical Course – Fall Senior year

◦ Mock Codes, Chest Tubes Leadership Course – Spring Senior Year

◦ Working as a team, Being the nurse SNUAC – Post operative assessment of a client with a

C-section, Teaching, New born Assessment

Plan for incorporating clinical simulation into curriculum

Future Use New Curriculum

◦ Integrated Lab - more course objectives could be met using clinical simulation

◦ Streaming from sim lab to classroom for most courses

◦ Integration of Electronic Health Record

Plan for incorporating clinical simulation into curriculum

Space

Move to North Haven

What space is available for setting up a clinical simulation lab?

Renovate existing space Create a space for a

clinical simulation suite◦ Faculty need to work

closely with technology to describe technological needs for running a clinical simulation

Space One control room for

each simulation room◦ Use of desk microphones◦ Debriefing immediately

after simulation If using desk

microphones do not have rooms set up with patient rooms back to back, sound from one room interfere with sound from other room

Deciding on Mannequin(s) Budget Program/course

objectives

Fidelity and environment

What is essential for learning?

Fidelity depends on learning outcomes

A realistic environment as possible is necessary for simulating a patient care scenario and the promotion of clinical reasoning

Cost and Waste

Funding

100,000.00 WOW!!!!!

Grants, School budget, University budget

Cost of mannequin (40-60K) Cost of room construction Cost of AV equipment (20K) Cost of related equipment (bed,

etc) Cost of maintenance Cost of training Cost of staff

Faculty Expert(s)

Super Clinical Simulation Educator

At least one faculty must develop expertise ◦ Nursing knowledge◦ Teaching knowledge◦ Simulation knowledge◦ Technology knowledge

Literature SUN conferences Laerdal Training Other institutions Practice, Practice, Practice!!!

Faculty buy-in You cannot do it alone!! Faculty education -

Expert should educate faculty on potential of clinical simulation◦ Literature◦ Demonstration◦ Student testimony ◦ Outcome measurement ◦ Institutional Research

Faculty Education

Gonna fly now

Laerdal SUN Conferences Mentoring Discussion

◦ Technology ◦ Scenarios

Role play Demonstration Return demonstration Technology Support

Management of student experiences

Began with 80 juniors 140 juniors

◦ 45 minute session fall◦ 45 minutes session spring◦ Maternity experience spring

50 SNUAC students ◦ 1 hour session

140 seniors ◦ Mock codes in fall ◦ Capstone simulation

Where is clinical simulation placed in the curriculum◦ Lab, Course, Clinical

Is it used in place of clinical time? How is credit for preparation and successful meeting

of objectives given? How is faculty time managed, credits? How does clinical simulation affect faculty work load? Will full-time and/or adjunct faculty be used for

teaching Will simulation technicians be used to run

programmed scenarios?

Management of students

Clinical Simulation Policy (should be included in syllabus or handbook ◦ Stick to policy unless unusual circumstances

Orientation process (video, hands on) Number of practice sessions

◦ Limited, unlimited Evaluation - Number of times student will be allowed repeat

experience ◦ How will this affect grade/passing of course or course component

Remediation ◦ Opportunities for practice, mandatory/voluntary

Single or group/team experiences ◦ Objectives, faculty resources, technology

Length of experience ◦ Objectives, type of scenario

Number of instructors needed to meet program needs Scheduling

◦ Wiki

Management of student experiences

Selling the Program University Administration Students are asking about

clinical simulation during open house

Parents impressed with simulation as teaching/learning strategy

Health care facilities recognize significance of clinical simulation experiences

Getting the word out to other departments in the University

Interdisciplinary Use Began with nursing Individuals in other

departments (OT, PT) contacted Nursing

Physician Assistant students Who will set up faculty

training sessions and be responsible for training

Once faculty are oriented, nursing signs off

Interdisciplinary Use

Roles develop over time To meet needs

Concerns – Scheduling Determining departmental

needs from all departments Extra workload on current

Laboratory Coordinator Need for Development of a

Laboratory Manager who is responsible for training, student orientation, troubleshooting, budgeting, scheduling and simulation set up for all departments

Approved for 5 extra rooms

Dr. Barrere

Faculty Experience

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